Femoral tunnel position in anterior cruciate ligament reconstruction usingthree techniques. A cadaver study

The possibility of achieving correct deep femoral tunnel positioning during anterior cruciate ligament (ACL) reconstruction with the double incision t echnique (DT), the transtibial technique (TT), and the anteromedial techniq ue (AM) was evaluated in 30 cadaver knees. A reference hole was made just d eep to the insertion of the anteromedial bundle of the ACL through an anter omedial arthrotomy. In the DI technique, a Kirshner wire was inserted outsi de-in using a rear entry C guide. In the TT and AM techniques, the K-wire w as inserted inside-out through the tibial tunnel and through the arthrotomy , respectively. The reference hole could be achieved with each technique. U sing lateral radiographs, the superficial aspect of the intra-articular exi t of the femoral tunnel was found to be located on average at 36%, 36%, and 34% of the width of the condyles from the posterior margin (NS). None of t he holes was more anterior than 40%. In conclusion, a deep femoral funnel p ositioning could be achieved with each technique. The choice of technique m ust be based on the surgeon's preference and clinical results.